Sweet, Sweet Karma

I usually vent about work here but this time I'm telling a story about sweet Karma.  I'm changing the names (for obvious reasons).

A few days ago I was assigned to be float nurse and to give lunch breaks.  I took an ambulance report, a 20 year old male patient who had a seizure.  I receive word he is being non-compliant so the EMTs administered 5mg of versed to help him calm down.

On arrival to the room I see George accompanied by his mother and father figure (no clue if it's his dad, where I live it's not unusual to have a large age gap between husband and wife).  During triage I recognized him but unable to figure out where from.  I ask George if he wanted help.  He only agreed to let me get vital signs on him.  As I attempted to get a temperature, his charming personality shone through and he became combative.

After a few short minutes of George verbally abusing everyone in the room I make sure he is oriented.  When he shows he is mentally competent I asked if he wanted treatment.  To my surprise he refused.  

George's mother then spoke up and demanded we treat him.  I explain to the mother that George is an adult and we cannot force treatment on him.  She continued to demand that we treat him so I explain a second time that it's against the law to give treatment to anyone who refuses. I then explain the only way we can treat someone who refuses is if they lacked capacity to make his own decisions.  She then asked if we could at least medicate George, I explained I would have to speak to the doctor.  

Mother then went off on me.  She claimed she did not like my answers and I could have worded them differently.  She continued stating we need to try something and she did not like that I wasn't going to do anything.  I apologized that we couldn't do anything to help but reiterated he had refused. 

As I stepped out of the room she asked to have another nurse take care of them.  Ignoring that statement I explained the situation to the doctor, the refusal and the other behaviors that happened.  He informed me he would return to the room and talk to George and his family.

As I started documenting on the conversation I was able to place where I knew George.  Several years ago I took care of him. At 16 he was a healthy young male with no medical history.  He suffered a seizure without any reason.  George came to the ER and I took care of him.  He had a wonderful personality, refused treatment and treated everyone like crap.  His mother was even a victim of his verbal abuse.  

After several hours of refusing treatment and verbally abusing everyone George was told if he could walk around the room without having any problems he would be able to leave.  Unfortunately for him shortly after he stood up he had a grand maul seizure.  I helped him to the floor and my coworker did abdominal thrusts (he had a mouthful of crackers).

George's mother finally stepped into her role as a mother and played the trump card, "I'm mom, you're the minor, you're getting treatment."  She apologized multiple times for his behavior and thanked us for helping as much as we did.  He was transferred out and never thought about him again.

So four years and George's charming personality hasn't really changed.  Shocker.

The verbal abuse in the room continues, George's mom calls the attending doctor an asshole, security is called to have them escorted out of the ER.  When security gets there George's family refuses to leave and demand that we treat George.  The security guard explains to them that he has to defer to the charge nurse to figure out what to do since they didn't want to leave.

Again, I am the float nurse relieving lunches.  The charge nurse has stepped out for her lunch break leaving me in charge.  Pointing out again they treated me like crap and did not like the way I treated them and the way I explained things to them.

The security guard asks who is in charge, I tell them it's me.  When I walk into the room the George's mom, wide eyed, says "Oh, you're in charge?"

The look on her face and her reaction were priceless.  I wish I could see it again, over and over.    

To finish the story, George and his family left without George getting any treatment.  I did notice that he no longer had a mouth full of teeth like he did when he was 16, his lovely personality must have helped him lose a few over the years.